Department of Dermatology, Faculty of Medicine, Oita University, Yufu, Japan.
Department of Diagnostic Pathology, Faculty of Medicine, Oita University, Yufu, Japan.
J Dermatol. 2019 May;46(5):409-412. doi: 10.1111/1346-8138.14862. Epub 2019 Apr 1.
A case of severe fever with thrombocytopenia syndrome (SFTS) in which a skin biopsy from the tick-bite region was analyzed is reported. The patient was a 72-year-old woman who developed fever and thrombocytopenia after a tick bite. SFTS was diagnosed from polymerase chain reaction (PCR) analysis of a blood sample. Histopathological analysis of a skin biopsy specimen from the tick-bite region showed CD20-positive perivascular and interstitial immunoblastic cells, which were positive to anti-SFTS virus (SFTSV) nucleoprotein antibody. In addition, SFTSV RNA was detected by real-time PCR from this biopsy specimen. Moreover, hemophagocytosis was also found in the tick-bite region. To the best of our knowledge, this is the first report to analyze the details of the tick-bite region of skin in SFTS, and the first to detect virus-infected cells in the skin. The present findings may help elucidate the mechanisms of entry of SFTSV.
现报道 1 例重症发热伴血小板减少综合征（SFTS）病例，对蜱叮咬部位的皮肤活检进行了分析。患者为 72 岁女性，蜱叮咬后出现发热和血小板减少。通过血液样本聚合酶链反应（PCR）分析诊断为 SFTS。蜱叮咬部位皮肤活检的组织病理学分析显示，CD20 阳性的血管周围和间质免疫母细胞对 SFTS 病毒（SFTSV）核蛋白抗体呈阳性。此外，从该活检标本中通过实时 PCR 检测到 SFTSV RNA。此外，在蜱叮咬部位还发现了噬血细胞现象。据我们所知，这是首例分析 SFTS 皮肤蜱叮咬部位细节的报告，也是首例在皮肤中检测到感染病毒的细胞。这些发现可能有助于阐明 SFTSV 进入的机制。
